Fibroids are growths that develop in and around the womb. They are non-cancerous and are made
up of muscle cells and the fibrous tissue. They develop from the walls of the womb, otherwise
known as uterus. This is the organ where the baby grows during pregnancy. The wall of the
womb is made up of quite thick muscle layer and from this muscle layer growths appear
which are known as fibroids. These are supplied by blood vessels and these are hormonally
dependent. They are more common within the age group of 30 to 50. They stop growing and
sometimes they stink after menopause.
Not all fibroid will cause problem. It will depend on how many of them are, how big they
are and most importantly where are they located within the uterus. They can actually grow
within the muscle layer, they can grow outside the muscle, or sometimes they can grow within
the cavity. If they continue to grow within the muscle layer or if they are growing outside,
they can grow really big. They do not usually grow very big if they are growing within the
cavity. Now, if they are growing within the muscle layer or growing outside, they can
cause pressure symptoms by pressing on the other organs. For example, if they are growing
from the front wall of the uterus, they can cause a pressure on the bladder needing the
patient to go to the toilet more frequently. They can cause the sensation of heaviness
lower down. On the contrary, if they are growing within the cavity, they can cause all sorts
of problem with the period like irregular period, heavy period and painful period. So,
if you have problem with the heaviness down below, if you can feel a lump in your lower
part of your tummy, or if you're having irregular, heavy and painful period, you should seek
advice from your GP who will then organise an ultrasound scan to check the fibroids.
Fibroids are really common. About 1/3 of women will have some sort of fibroids. Most of them
will be completely unaware that they will have it but they are more generally more common
in the afro-Caribbean women, in the age group between 30 and 50, the patients who are a
bit overweight or obese and the patients who did not have any children. However, not all
of them will experience problem. Only 1/3 of the ladies with the fibroids will have
some sort of problem that will need a treatment.
The treatment of the fibroid will depend on patient symptoms and the fibroids itself.
Most importantly, we need to consider if the patient has completed her family or not, because
the mainstay of the treatment of the fibroid is surgery. We need to remove the fibroids.
There is no, unfortunately, a medical treatment available which can cure the fibroids. If
the patient has completed her family and if the fibroids are big and many, then hysterectomy
is the main option. If the patient wants to keep the option of the future fertility open:
they want to try for more babies in the future, then we need to remove the fibroids. That
will depend on the size and the location of the fibroid. If the fibroids are growing within
the cavity, we need to remove them by a camera with a special instrument, if they are growing
outside the cavity then they will need a major surgery called myomectomy. More recently newer
techniques are being developed, one of them is called urine artery embolization. It is
done by the radiologists where they will put microscopic PVC glue to block the blood supply
to the fibroid from uterine artery so that the fibroids can stop growing and sometimes
string. Newer technologies are also being developed which are magnetic resonance guided
high-frequency ultrasound or a laser ablation, but these are highly specialised areas. If
you are suffering from fibroids, you need to seek advice from the GP and get a referral
to the specialist so that he or she can plan the management of the fibroid better.